The Jury is in

From what you said I am not sure where they got the 4+3 since all the positive cores you mention were 3+4. Usually the overall Gleason score is simply the Gleason score for the highest risk single core (where 4+3 is higher risk than 3+4).

Are you sure you transcribed the Gleason scores for the various cores correctly?

Man, sorry to hear that. But glad you're sending your slides to JHU--probably best to hear what you get back from there before you go any further on any decisions, particularly regarding the 3+4, versus 4+3 issue. (Just what you wanted...more waiting.) Glad to hear your uro isn't pushy about any particular treatment.

All that I can add at this time is you still have every reason to think you'll do fine. Sadly, you'll have to go down the rabbit hole, but most of us come out okay on the other side. And we're here to help during the journey. Good luck to you.

0311 -

Here's a question that has nothing to do with your diagnosis, which, granted, is enough to deal with right now, but it's a question that's important enough to bring up, even at this time, if it applies to you.

You ended your first post above with "Semper Fi." I assume that means you served in the U.S. Marines? And I also noted from your earlier thread that you give your birth date as 1952. That would suggest, since the timing is right, that you may have served with the Marines in Vietnam. Is that true?

If it is true that (1) you did serve in the U.S. Marines and were honorably discharged, and (2) at any point during your time in the Marines you did a tour in Vietnam, then you are probably eligible for U.S. government benefits for a veteran with prostate cancer, which are actually rather generous. (I'm a Vietnam veteran myself, Army, and receive these benefits).

But, again, you have to have served in Vietnam (or, as I suddenly recall, certain areas of the DMZ in Korea also qualify). If you did, perhaps you are already aware of these benefits. If not, and you actually were in Vietnam, please do post again on this thread to indicate that you are not aware of the benefits, and I will be happy to post and describe them.

G7 definitely puts you in the low-intermediate risk group, which suggests that (a) you have time to make an informed decision and (b) cure is definitely a useable term.

Yes, it's a kick in the teeth, but a manageable kick. Hang in there. When you get the second opinion then you can start working on your decision.

311,

Ditto what 81GyGuy said. I found out about the VA's Agent Orange program way too late and left a lot of money on the table as a consequence. If you served in-country Vietnam you would be entitled to full disability payments from the time of diagnosis until you have completed successful treatment - typically 6 months after completion of surgery or radiation treatment if your follow-up results show remission. You could then be eligible for lesser benefits if you have residual effects from your treatment. These benefits are paid monthly-- but are retroactive only from the time of your filing for them. So prompt filing upon diagnosis is very important.

Just want to echo the advice about contacting Dr Epstein at JH directly. Steve talked with him twice. Both times he was very generous with his time. He clearly explained why his pathology report differed from the one we got from the Cleveland Clinic and he also gave his opinion regarding treatment.

So sorry about the results you got from the BX but you'll have plenty of treatment options, all of which can offer you a cure.

Take care.

Hello Everyone,the 4+3 was explained by Uro,my Wife says.I was in a little fog at that moment.That was from the fusion guided spot,lesion, that was noted on the MRI.I still dont understand as the heart shaped diagram that is on the print out shows 2 areas with a a little black bar that shows 25% and a 35% and each of them say 3+4.John Hopkins hopefully will not upgrade that to 8.Geez.Thanks for everyones concern.

Hey Bohemond,thank you also for the tip.I have a Marine buddy from Haverhill, Mass.Mike Moran,done a tour with him.Sometimes its a small world.Never know.Thank You

0311 -

(This post is a bit long, I apologize for that, but please do read it through. I believe it contains information that you will find useful)

First, my forum username, 81GyGuy, is not from the 81mm mortar (although that's a good guess!) but rather from the fact that during my radiation treatment (IMRT) I maxed out at 81 Grays of radiation. So I'm the "guy" who got "81gy" of radiation! But thanks for asking!

But now to the important matter of your military benefits. In their posts above, Bohemond and John TX have posted good and accurate advice on what you can do to start looking into the government benefits which you have earned. And earned not just through one, but through two tours of duty in Vietnam! So you are certainly entitled to them!

I would like to try and add a little more to what they have already said. First, it's really good advice to enlist the help of a Veterans Service Officer to assist you. As John TX notes, they are often available at county level. But you also say that you "have friends at the VFW that help with claims." Check with them. Perhaps they have a level of experience that can help you, or else they can refer you to a VSO who can. If there is a VA hospital near where you are, you can find assistance there. Other veterans organizations besides the VFW, such as the American Legion that may be where you are, also sponsor veterans' applications for benefits. And there is always the Internet for gaining information, although of course the quality of websites claiming to offer assistance varies. If you're interested, here is a Vietnam veterans' site that I have been following for some years now (occasionally posting there), and I can vouch for them as "good guys," and they offer good advice to veterans:

vets.yuku.com/

(Disclaimer: of course I get nothing for recommending this site, but I am convinced that they are on the up-and-up and a good, useful site for benefits information).

I want to say something specific about the financial compensation you will receive if you do apply for and are approved for benefits as a Vietnam veteran who has developed prostate cancer: the government will pay you between $ 17,000 and $ 18,000. Also, this money will be tax-free, as the government considers it as compensation and not income. This is because while during your treatment, for which the VA assigns a standard six months in duration, the VA classes you as "temporary 100% disabled," and entitles you to the highest compensation rate, "100% disabled," for that six months.

The reason I can't be more specific than to say it's somewhere between $ 17,000 and $ 18,000 is because the rate will vary according to a number of factors, such as having a spouse, dependents (including dependent parents), and other factors. This page on the VA website goes into more detail and can help you arrive at a probable figure that would apply in your case:

www.benefits.va.gov/COMPENSATION/resources_comp01.asp

If you do get into applying for benefits through the VA, I would also recommend looking at the publication "Federal Benefits For Veterans, Dependents and Survivors." It is available on the VA website, and is a good starting point for finding out what you need to do:

www.va.gov/opa/publications/benefits_book.asp

There are numerous other government benefits available through the VA other than monetary, such as insurance, license discounts, benefits for dependents, etc. which I could mention in another post if you're interested (this one is getting to be long enough). Let me know.

Oh, as was also noted in an earlier post, following the above mentioned period of six months which the government allows for treatment, you would be re-evaluated at a "C&P" (Compensation and Pension) medical exam, at which any lingering side effects and/or disabilities will be identified, and your disability percentage (which has temporarily been at 100%) re-evaluated and likely re-adjusted to a lower percentage, assuming the treatment you received was successful).

Whew! I know I have just thrown a lot of information at you, but I hope it will be useful to you, and might encourage you to look into getting the benefits you deserve. I would imagine the prospect of getting close to $ 18,000 just for applying (and you will qualify – the benefit is "presumptive," all you need to get it is your military discharge form DD-214, along with an official diagnosis of prostate cancer from a reputable source, such as Bostwick or Epstein) would make applying worth while.

But one more word of advice, and it's important: apply for benefits before you begin your treatment. If you apply for them during or after you have begun treatment, you may have to submit paperwork that the treatment is "medically necessary," or such, and if application is made after treatment you will not quality for the "100% temporary disability" and the money that goes with it, as described above.

Well that's enough. I do hope this helps, and that if you do pursue benefits (do so, you're entitled to them!) that it all works out well for you!

Good luck, and keep us updated on how it goes!

0311, just a tidbit that I have picked-up from other vets along the way—and perhaps others can corroborate—but note that VA benefits begin based on your application date and don't get backdated beyond that. The point here is that you are likely due these benefits, so don't delay initiating the application process...

Hello Everyone,I have updated my signature.Any and all suggestions will be considered.Just had the Biopsy results yesterday.Uro,talked about Surgery and IMRT,IGRT.Not to pushy.He didnt like Brachy? and said SBRT has no track record that ins.dont cover it.Anyway Im starting to devour info.Thank You all for your support and caring.

Hi 0311, sorry I have been quiet... business travel...

I saw you news and while it isn't what we hoped for it isn't horrible either, just intermediate with plenty of available options ahead of you and at least some time to breathe and continue your research. I know many shoulders here will be able to carry you better than I.

I think you've been around here long enough to know that you dare not listen to just one Uro... now your job is to triangulate around the different treatment options and challenge these guys. I'll start with "SBRT is not covered by insurance", that is just an ignorant URO; it blatantly IS COVERED by some insurance, BC/BS in Maryland for example. I have no idea about your insurance but it's worth investigating and even appealing. Look up 'CKcoalition' to learn more. I think TA will also be along to tell you that SBRT has 7-8 years of positive track record, so he's wrong there also.

I'm no advocate for SBRT either way, just using it as an example of you can't trust one voice; you need 'tie-breakers'... dang I should know. The Brachy options would seem entirely appropriate also, particularly HDR.

"Play the ball from where it lands"... not from where some other bugger moves it to.

The disinformation and ignorance we constantly run into drives me nuts and I don't want to see you fall victim to it. Cast your net wide and downselect from there; the guys here will help.

So AS is probably off the table... at least that's one you won't have to worry about/through!

Meanwhile Dr Epstein needs to figure in your future, until you have that 2nd opinion it is largely speculation; especially given Quest. GET YOUR PROSTATE UNTO HE! There is an online form to fill out... but I also have his email address if you PM me

From what I read, you have faced far worse odds than these, you now know your enemy and where he is.

Wish I could take you for a beer... maybe you can get to GFMPH in FL next year and I'll pour one down your throat

Post Edited (Paul65) : 12/3/2015 12:10:31 PM (GMT-7)